What are the four F's of ovarian torsion?

Female, Fat, Forty, Fertile = gall stones. We've heard that one before.

I now propose the four F's of ovarian torsion:

1. Female - goes w/o saying


2. Fifty or less - affects women of reproductive age and younger (including adolescents, children and neonates)


3. Funky ovary - 50 - 80% of ovarian torsion cases are associated with adenexal pathologic conditions such as ovarian tumors and cysts. When imaged using either pelvic ultrasound (modality traditionally used to image pelvic organs), CT or MR there is often an enlarged ovary or ovarian complex noted. The absence of doppler signal on duplex and color doppler imaging will clinch the diagnosis; however, its presence cannot eliminate the diagnosis.


4. Failure to diagnose alternative cause of significant lower pelvic pain - abdominal pain is the most reliable symptom of torsion but is nonspecific.

Source

Andreotti, R. MD et al. "The Sonographic Diagnosis of Ovarian Torsion: Pearls and Pitfalls." Ultrasound Clinics. 2007. 155-166.